Citation

Cheeta S, Schifano F, Oyefeso A, Webb L, Ghodse AH. Br. J. Psychiatry 2004; 184: 41-47.

Affiliation

Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London, UK. scheeta@sghms.ac.uk

Comment In:

Br J Psychiatry 2004;.

Copyright

(Copyright © 2004, Royal College of Psychiatry)

DOI

unavailable

PMID

14702226

Abstract

BACKGROUND: Deaths from antidepressants continue to account for a substantial proportion of drug-related deaths. AIMS: To investigate the relative toxicity of the major classes of antidepressant drugs, with the specific objective of assessing this in relation to the cause of death; and to analyse the deaths where there were multiple mentions of antidepressant drugs or other psychoactive drugs with antidepressants. METHOD: Mortality data were collected from the National Programme of Substance Abuse Deaths, and antidepressant prescription data were collected. RESULTS: Most deaths from antidepressant drugs were suicides (80%). Tricyclic antidepressants (TCAs) accounted for more drug mentions than did other antidepressant drugs (12 per million prescriptions). Selective serotonin reuptake inhibitors (SSRIs) were associated with a significantly lower risk of toxicity, but 93% of deaths from SSRIs occurred in combination with other drugs, especially TCAs (24.5%). In 'combination' deaths patients were significantly more likely to have had a history of drug misuse. CONCLUSIONS: The efficacy and safety of augmentation therapy with TCAs in SSRI-resistant patients should be monitored carefully, and patients prescribed antidepressants should be screened for drug use/misuse.

Language: en